Endocrinology, Diabetes and Metabolism最新文献

{"title":"The Effect of Integrated Lifestyle Intervention Incorporating Calorie-Carbohydrate Restriction With or Without Time-Restricted Feeding for Remission of Type 2 Diabetes (DIREM): A Single Blind Randomised Controlled Trial","authors":"Negin Badrooj,&nbsp;Alireza Esteghamati,&nbsp;Kurosh Djafarian,&nbsp;Mir Saeed Yekaninejad,&nbsp;Saba Mohammadpour,&nbsp;Vida Dankoob,&nbsp;Sahar Karimpour Reyhan,&nbsp;Mahsa Abbaszade,&nbsp;Sara Emamgholipour,&nbsp;Sakineh Shab-Bidar","doi":"10.1002/edm2.70209","DOIUrl":"10.1002/edm2.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We conducted the diet and diabetes remission (DIREM) study to assess whether an integrated lifestyle intervention would lead to achieving remission in type 2 diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients with type 2 diabetes were randomly assigned to calorie-carbohydrate restriction (CCR) group, intermittent fasting with calorie-carbohydrate restriction (IFCCR), or usual care group (control). The total study duration was 6 months, consisting of two phases: a 12-week integrated lifestyle intervention (ILI) phase, followed by a 12-week maintenance and structured monitoring (MSM) phase. The intervention was presented in the form of a structured behavioural model and also emphasised physical activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and twenty participants were randomly assigned to the study. Diabetes remission occurred in 9 (22.5%) of 40 participants in the CCR group (OR (CCR vs. Control) = 11.7, 95% CI: 1.4–98.3; <i>p</i> = 0.024), 12 (30.0%) of 40 participants in the IFCCR group (OR (IFCCR vs. Control) = 18.1, 95% CI: 2.2–151.0; <i>p</i> = 0.007) and 1 (2.5%) of 40 participants in the control group. The odds of remission were higher in the IFCCR group compared to the CCR group, but it was not significant (OR (IFCCR vs. CCR) = 1.5, 95% CI: 0.6–4.3; <i>p</i> = 0.4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both calorie-carbohydrate restriction alone and in combination with intermittent fasting significantly improved glycemic control and induced diabetes remission compared with the control group. No significant difference was found between the two interventions. Larger long-term studies are needed to confirm these findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This trial was registered in the Iranian Registry of Clinical Trials (IRCT), IRCT20240418061519N1 (https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20240418061519N1)</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alanine Aminotransferase Elevation at Diagnosis of Youth-Onset Type 2 Diabetes: Prevalence, Predictors, and One-Year Outcomes","authors":"Sean DeLacey,&nbsp;Wenya Chen,&nbsp;Adesh Ranganna,&nbsp;Siyuan Feng,&nbsp;Mark Fishbein,&nbsp;Monica Bianco","doi":"10.1002/edm2.70211","DOIUrl":"10.1002/edm2.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) and Type 2 Diabetes (T2D) are components of insulin resistance, but the prevalence of MASLD at the diagnosis of youth-onset T2D is unknown. We aimed to describe the prevalence of alanine aminotransferase (ALT) elevation, a biomarker for MASLD, in youth-onset T2D at diagnosis and after one year and investigate factors associated with ALT elevation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-centre retrospective cohort study was conducted of patients (age ≤ 21 years) diagnosed with T2D between 1/1/2010 and 31/12/2021, with ALT available at diagnosis. ALT elevation was defined as being greater than 1.5 times the upper range of normal based on patient sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the cohort (<i>n</i> = 438), 58% of patients had ALT elevation at T2D diagnosis. Hispanic patients had higher odds of ALT elevation than non-Hispanic Black patients (<i>p</i> &lt; 0.001), and lower HbA1c at diagnosis was associated with higher odds of ALT elevation (<i>p</i> &lt; 0.001). Among patients followed for one year (<i>n</i> = 141), the prevalence of ALT elevation decreased from 65% to 47%. ALT at diagnosis was not associated with a change in Haemoglobin A1C (HbA1c) from diagnosis to one year of follow-up, nor was HbA1c at diagnosis associated with a change in ALT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ALT elevation is common at T2D diagnosis in youth. HbA1c is negatively associated with ALT elevation at diagnosis, but ALT and HbA1c at diagnosis did not impact the change in the corresponding marker at one year. The prevalence of elevated ALT varies between groups, and analysis of disease course within subpopulations is pertinent.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Hybrid Closed Loop Systems in Pregnancy: A Retrospective Study of Women With Type 1 Diabetes","authors":"Dimitra Stathi,&nbsp;Katharine Hunt,&nbsp;Helen Rogers,&nbsp;Konstantinos S. Kechagias,&nbsp;Anna Brackenridge","doi":"10.1002/edm2.70195","DOIUrl":"10.1002/edm2.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hybrid closed loop systems (HCLS) lead to improved glycaemic outcomes without the increased burden of hypoglycemia. CamAPS and Mendtronic 780G are the only systems licensed for use in pregnancy in Europe; however, all the commercially available algorithms are currently used in clinical practice. The aim of this study is to share our experience of using HCLS during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective study. We reviewed records at two teaching hospitals from January 2018–March 2023 and identified 42 women of whom 42.8% (<i>n</i> = 18) were established on HCLS prior to pregnancy and 57.2% (<i>n</i> = 24) started during pregnancy at a median of 12 weeks of gestation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Time in pregnancy target range (TIRp) (3.5–7.8 mmol/L) increased from 57% (44.5%–65%) (median, IQR) at first visit to 73% (65%–82%) (<i>p</i> &lt; 0.001) at 34 weeks of gestation with 66% achieving ≥ 70% at 34 weeks. Time below range (TBR) glucose did not change significantly. There was no significant difference in TIRp at 8 or 34 weeks between those started on HCLS before versus during pregnancy. TBR at first visit was lower in those established on HCLS pre-pregnancy versus those started in pregnancy (p: 0.04) with no difference between groups at 34 weeks. There were no admissions for diabetic ketoacidosis (DKA) or severe hypoglycemia. Eleven infants (26.8%) had birthweight over 90th percentile and neonatal hypoglycemia was recorded in 9 cases (22%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In our cohort, HCLS in pregnancy was effective, with 66% achieving ≥ 70% TIRp, and appears to be safe with low TBR and no episodes of DKA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dairy Intake and Type 2 Diabetes Mellitus in Iranian Older Adults: Insights From the Baseline Phase of the Birjand Longitudinal Aging Study","authors":"Mahboubeh Darabi,&nbsp;Amirmohammad Tajik,&nbsp;Mehraneh Movahedi Aliabadi,&nbsp;Zeinab Shakeri,&nbsp;Maryam Mohammadi,&nbsp;Hossein Fakhrzadeh,&nbsp;Mitra Moudi,&nbsp;Masoumeh Khorashadizadeh,&nbsp;Mehdi Varmaghani,&nbsp;Farshad Sharifi","doi":"10.1002/edm2.70196","DOIUrl":"10.1002/edm2.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Type 2 diabetes mellitus (T2DM) is a growing public health concern among older adults worldwide including in Iran. Despite extensive research on the metabolic effects of dairy products, their association with T2DM remains inconsistent, particularly in non-Western populations. This study examined the relationship between dairy consumption including specific types, and T2DM among older adults in eastern Iran.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study utilised baseline data from the Birjand Longitudinal Aging Study (BLAS), which included community-dwelling adults aged 60 years and older. Dietary intake was assessed using structured questionnaires, and participants were categorised into tertiles based on dairy consumption (low, moderate, high). T2DM status was determined by FBS ≥ 126 mg/dL or a previous physician diagnosis. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for T2DM across different levels of dairy intake, adjusting for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 1348 participants were analysed, with an overall T2DM prevalence of 27.15%. Individuals in the highest tertiles of yogurt and cheese intake had significantly increased odds of T2DM (OR = 1.454, 95% CI = 1.08–2.20, <i>p</i> = 0.08; OR = 1.44, 95% CI = 1.04–2.00, <i>p</i> = 0.029). No significant association was found between milk consumption and T2DM risk. Total dairy consumption showed no significant association with T2DM in the fully adjusted model (OR = 1.42, 95% CI = 1.00–2.403, <i>p</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study reveals a complex association between dairy intake and the risk of T2DM in Iran, in which high consumption of yogurt and cheese was paradoxically associated with increased odds of disease. This finding may be explained by the high fat content of these products, residual confounding from unmeasured dietary patterns, or biological pathways related to diabetes pathology and gut microbiota modulation that were not captured in our analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Resmetirom and Efruxifermin for Metabolic Dysfunction-Associated Steatohepatitis: A Network Meta-Analysis of Randomized Controlled Trials","authors":"Doha Jaber,&nbsp;Inas Jaber,&nbsp;Ayah Abu Lehia,&nbsp;Thekrayat Asad,&nbsp;Hazem Ayesh","doi":"10.1002/edm2.70218","DOIUrl":"10.1002/edm2.70218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatohepatitis (MASH) is a progressive liver condition and a major cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. Resmetirom, a thyroid hormone receptor β agonist, and Efruxifermin, a fibroblast growth factor 21 analogue, have shown promise in improving hepatic fat fraction (HFF) and liver enzyme levels. This study systematically compares the efficacy and safety of Resmetirom and Efruxifermin in treating MASH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, Cochrane, and Scopus identified 211 studies, of which eight randomized controlled trials (RCTs) were included. Primary outcomes included reductions in liver enzyme levels. Secondary outcomes assessed HFF measured by magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF), as well as lipid profiles. Safety outcomes consist of serious adverse events and events leading to treatment discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Efruxifermin was associated with significant improvement in MRI-PDFF with an mean difference (MD) of −62.83% (95% CI: −72.30 to −53.36, <i>p</i> = 0.00), followed by Resmetirom with an MD of −37.15% (95% CI: −44.43 to −29.88, <i>p</i> = 0.00), additionally Efruxifermin was associated with significant reduction in aspartate transferase (AST) level, with an MD of −14.32 (95% CI: −23.92 to −4.72, <i>p</i> = 0.003), compared to Resmetirom (MD: −2.81; 95% CI: −12.40 to 6.79, <i>p</i> = 0.56). For lipid profiles, Efruxifermin showed a significant reduction in triglyceride levels with an MD of −36.95 (95% CI: −52.67 to −21.24, <i>p</i> = 0), while Resmetirom had an MD of −24.72 (95% CI: −33.31 to −16.14, <i>p</i> = 0.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Efruxifermin demonstrated a slightly greater effect on MRI-PDFF and AST, along with more favourable safety outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of Longitudinal Thyroid Hormone Levels Over the Years Before and After Patients Started on Levothyroxine","authors":"Michael Stedman,&nbsp;Peter Taylor,&nbsp;Ian Halsall,&nbsp;David Halsall,&nbsp;Buchi Okosieme,&nbsp;Suhani Bahl,&nbsp;Sangeeth Veluchamy,&nbsp;Lakdasa Premawardhana,&nbsp;Anthony A. Fryer,&nbsp;Colin Dayan,&nbsp;Adrian Heald","doi":"10.1002/edm2.70214","DOIUrl":"10.1002/edm2.70214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This retrospective study aimed to investigate how free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels change in the years pre- and post-initiation of levothyroxine (LT4). A better understanding of the relation between thyroid hormone replacement therapy and actual levels of TSH/FT4 in patients could allow more tailored and effective therapy for people with hypothyroidism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using de-identified citywide population health records, we were able to analyse TSH and FT4 results during the period 2012–2023 (12 years) for patients whose LT4 was started during 2015–2019 (5 years) and who also had a diagnosis recorded of primary hypothyroidism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before LT4 initiation, there was a slight rise in median TSH results over the previous years with a sharper increase in the 12 months prior to medication starting. Once on medication, TSH fell to levels significantly below the pre-medication levels. Between −6 and −2 years before initiation of LT4, median TSH increased from 4.0 to 4.9 mu/L and then in the last year before initiation to 6.4 mu/L. Once on medication the TSH fell to 3.8 mU/L then to 2.7 mU/L over subsequent years, which was significantly below the TSH level before LT4 prescribing was initiated. Median FT4 was low and falling slowly prior to medication starting. Once medication started, FT4 was higher year on year, in relation to increasing doses of LT4 with TSH correspondingly lower. Average daily LT4 dose continued to increase over the years following initiation, with a corresponding rise in FT4. The median LT4 dose for the treated group rose steadily from 49mcg to 69mcg daily.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This population-based retrospective study reflects varying responses in different patients, but with overall further evidence for increasing difference over time in FT4 and TSH in treated hypothyroid individuals versus euthyroid individuals. This has implications for how LT4 dose titration is conducted in treated hypothyroidism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13057418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Ecnoglutide in Type 2 Diabetes: A Systematic Review and Meta-Analysis","authors":"Mukesh Kumar,&nbsp;Sumet Kumar,&nbsp;Sheikh Muhammad Ebtehaj Ali,&nbsp;Hadia Qazi,&nbsp;Arshia Arif Janjua,&nbsp;Hanzlah Ahmed,&nbsp;Rayan Babar,&nbsp;Rumaisa Imtiaz Sheikh,&nbsp;Laksh Kumar,&nbsp;Sana Mohammad Ali,&nbsp;Fatima Hanif,&nbsp;Khizra Gul,&nbsp;Ayesha Sarwar Ali,&nbsp;Shehzadi Umme Rubab Bukhari,&nbsp;Adarsh Raja,&nbsp;Aayush Chaulagain","doi":"10.1002/edm2.70217","DOIUrl":"10.1002/edm2.70217","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Type 2 diabetes mellitus (T2DM) affects over 500 million people worldwide, with traditional therapies often failing to maintain long-term glycaemic control. Ecnoglutide, a novel long-acting GLP-1 receptor agonist, has emerged as a promising therapeutic option. This systematic review and meta-analysis evaluated the efficacy and safety of ecnoglutide in adults with T2DM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines, we systematically searched PubMed, Cochrane Library, ScienceDirect, ClinicalTrials.gov, and Google Scholar through September 2025. Randomized controlled trials comparing ecnoglutide with placebo or active comparators in adults with T2DM were included. Primary outcomes were changes in HbA1c and body weight. Secondary outcomes included fasting plasma glucose, insulin resistance markers, lipid profile, liver enzymes, and adverse events. Risk of bias was assessed using the Cochrane RoB-2 tool. Meta-analysis was performed using random-effects models, with mean differences and risk ratios calculated at 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four RCTs comprising 1643 participants (1162 receiving ecnoglutide, 444 controls) were included. Ecnoglutide significantly reduced HbA1c (MD = −0.44, 95% CI −0.55 to −0.33, <i>p</i> &lt; 0.00001), body weight (MD = −5.63, 95% CI −7.90 to −3.35, <i>p</i> &lt; 0.01), and fasting plasma glucose (MD = −0.81, 95% CI −1.03 to −0.59, <i>p</i> &lt; 0.00001). Improvements were observed in insulin sensitivity, lipid profile, and liver enzymes. Adverse events occurred more frequently with ecnoglutide (RR = 1.09, <i>p</i> &lt; 0.01), although predominantly gastrointestinal and mild-to-moderate, with no significant differences in serious adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ecnoglutide demonstrates robust efficacy in glycaemic control, weight reduction, and cardiometabolic parameters with an acceptable safety profile in adults with T2DM, supporting its therapeutic potential as a next-generation GLP-1 receptor agonist.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of and Comparative Outcomes for Digital and In-Person Interventions for Complex Obesity in a Diverse Urban Population","authors":"Majella O'Keeffe,&nbsp;Emiliano Pena-Altamira,&nbsp;Sumaya Shuriye,&nbsp;Danielle Dunk,&nbsp;Oliver Canfell,&nbsp;Rhys White,&nbsp;Alastair Duncan","doi":"10.1002/edm2.70215","DOIUrl":"10.1002/edm2.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Obesity management in the UK includes multicomponent weight and behavioural interventions delivered at Tier 3 of the NHS model of care. This study presents the impact of and comparative outcomes for the Tier 3 Southeast London Healthy Living programme (SELHLP) in a diverse population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The SELHLP is a multicomponent, multidisciplinary programme that includes face-to-face (F2F) and virtual (V) delivery. Two management strategies are offered: Balance, a weight behavioural intervention and Kickstart, a three-month total meal replacement intervention followed by a weight and behavioural intervention. Eligibility criteria were adults (≥ 18 years) with a BMI ≥ 35 kg/m². Baseline data and exit data were collected at session 9–12. Primary outcomes included weight change from baseline to programme completion; secondary outcomes included both clinical and behavioural outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Programme completers of both Balance and Kickstart were predominantly female (82% and 79% respectively). Among completers for Balance, weight change from baseline was −2.8 (8.4) kg for Balance F2F (<i>p</i> &lt; 0.001) and −5.1 (11.7) kg for Balance V (<i>p</i> &lt; 0.001). A similar trend was observed for Kickstart F2F −11 (13) kg and Kickstart V −11 (11) kg (<i>p</i> &lt; 0.001) but did not differ between service delivery models (<i>p</i> &gt; 0.005). 34% of participants of the combined Balance and Kickstart programmes lost ≥ 5% of initial weight, −10.7% and −18% weight loss respectively. Black participants and women were less likely to achieve ≥ 5% weight loss in both programmes, but deprivation status had no effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The SELHLP resulted in significant weight loss, but weight loss varied by service delivery, ethnicity and sex. Future efforts should focus on cultural salience and digitisation of Tier 3 programmes to support better engagement and completion among participants of Black ethnicity. Tailoring of Tier 3 interventions and triaging of participants at the onset should be investigated to improve both patient and service outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Foot Complications Among Individuals With Type 2 Diabetes Mellitus in Semi-Urban Udupi District","authors":"G. Arun Maiya,&nbsp;Shubha Hebbar,&nbsp;Prabhath Kalkura,&nbsp;J. Vennila,&nbsp;Tina Agnes,&nbsp;Shetty Shrija Jaya,&nbsp;Manjunath Hande,&nbsp;Shashikiran Umakanth,&nbsp;K. N. Shivashankara,&nbsp;B. Ananthakrishna Shastri,&nbsp;David G. Armstrong,&nbsp;Ashu Rastogi,&nbsp;Neil Reeves,&nbsp;U. Anushree","doi":"10.1002/edm2.70169","DOIUrl":"10.1002/edm2.70169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Diabetic foot disorders continue to be among the most prevalent and overlooked complications associated with diabetes. The aim of this study was to determine the factors associated with diabetic foot complications in semi-urban Udupi District.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was a cross-sectional study. 25,000 individuals living in Udupi district were screened for <i>diabetes mellitus</i>, and among them, 3844 individuals were found to have <i>type-</i>2 <i>diabetes mellitus (T2DM)</i>. Further, detailed anthropometry and foot assessments were performed for these individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, a total of 3844 participants aged between 40 and 75 years with T2DM were screened to determine the prevalence of foot complications. The mean age of the study participants was 59.2 years (±11.7). Of the participants, 41.3% were male and 58.7% were female. Neuropathy was present in 9.8% of the participants, and 5.6% of the participants had a foot ulcer. Among 3844 individuals, sensation, pedal pulse, vibration, and foot care awareness were factors associated with diabetic foot complications. The Bayesian Neural Network (BNN) model was also developed, and showed good predictive performance, with an AUC of 0.901 for the right foot and 0.922 for the left foot. The BNN results also show strong predictive performance. Both models predicted diabetic foot complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Prevalence of foot complications is high in the Udupi district, and the presence of risk factors puts the individual at risk for serious complications of T2DM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lost in Transcription: Frequency of Inaccurate Manually Documented Point-of-Care Blood Glucose and Ketone Measures in Hospital","authors":"Ali Hazara,&nbsp;Rahul D. Barmanray,&nbsp;Ray Wang,&nbsp;Mervyn Kyi,&nbsp;Spiros Fourlanos","doi":"10.1002/edm2.70212","DOIUrl":"10.1002/edm2.70212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Optimal inpatient diabetes management requires accurate blood glucose (BG) and ketone (BK) documentation. In 2019, Royal Melbourne Hospital implemented hospital-wide networked blood glucose monitoring (NBGM) (NovaBiomed StatStrip), which automatically uploads BG/BK values to point-of-care device software (Bioconnect). Until electronic health record (EHR) implementation in 2020, nurses manually recorded BG/BK data into paper-records, enabling blinded gold-standard accuracy assessment by digital software. This study evaluated the accuracy and potential clinical significance of inaccurate manual POC BG/BK values compared with NBGM records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>DINGO POC, a sub-analysis of the Diabetes IN-hospital: Glucose and Outcomes (DINGO) study, audited paper-based glucose charts against NBGM-uploaded BG/BK values and BG time-stamps to identify manual transcription inaccuracies. Discrepancy rates, magnitude and potential clinical significance were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>4391 BG and 378 BK NBGM measures from 250 admissions over a two-month period were assessed. Of BG measures, 325 (7.4%) were not recorded in patient charts and 558 (13%) were inaccurate. 302 (54%) inaccurate BGs had potentially clinically significant discrepancies (≥ 0.4 mmol/L). 1570 (36%) BG time-stamps were recorded inaccurately, and 329 (7.5%) were not recorded. 524 (33%) inaccurate BG time-stamps had discrepancies &gt; 15 min. Of BK measures, 153 (41%) were not recorded and 18 (8%) were transcribed inaccurately. Inaccuracy rates were similar across wards and patient groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Manual transcription of POC BG/BK values and time-stamps, evaluated against blinded concurrent gold-standard digital software, was often inaccurate with potential for clinical harm. Implementation of hospital-wide NBGM systems with automated POC BG/BK upload to EHRs may mitigate manual transcription errors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36522,"journal":{"name":"Endocrinology, Diabetes and Metabolism","volume":"9 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/edm2.70212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}